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World Journal of Surgery
Published in: World Journal of Surgery 6/2021

Open Access 01-06-2021 | Sarcopenia | Original Scientific Report

A New Preoperative Risk Score for Predicting Postoperative Complications in Elderly Patients Undergoing Hepatectomy

Authors: Koichi Tomita, Itsuki Koganezawa, Masashi Nakagawa, Shigeto Ochiai, Takahiro Gunji, Kei Yokozuka, Yosuke Ozawa, Kosuke Hikita, Toshimichi Kobayashi, Toru Sano, Naokazu Chiba, Shigeyuki Kawachi

Published in: World Journal of Surgery | Issue 6/2021

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Abstract

Background

Postoperative complications are not rare in the elderly population after hepatectomy. However, predicting postoperative risk in elderly patients undergoing hepatectomy is not easy. We aimed to develop a new preoperative evaluation method to predict postoperative complications in patients above 65 years of age using biological impedance analysis (BIA).

Methods

Clinical data of 59 consecutive patients (aged 65 years or older) who underwent hepatectomy at our institution between 2017 and 2020 were retrospectively analyzed. Risk factors for postoperative complications (Clavien-Dindo ≥ III) were evaluated using multivariate regression analysis. Additionally, a new preoperative risk score was developed for predicting postoperative complications.

Results

Fifteen patients (25.4%) had postoperative complications, with biliary fistula being the most common complication. Abnormal skeletal muscle mass index from BIA and type of surgical procedure were found to be independent risk factors in the multivariate analysis. These two variables and preoperative serum albumin levels were used for developing the risk score. The postoperative complication rate was 0.0% with a risk score of ≤ 1 and 57.1% with a risk score of ≥ 4. The area under the receiver operating characteristic curve of the risk score was 0.810 (p = 0.001), which was better than that of other known surgical risk indexes.

Conclusion

Decreased skeletal muscle and the type of surgical procedure for hepatectomy were independent risk factors for postoperative complications after elective hepatectomy in elderly patients. The new preoperative risk score is simple, easy to perform, and will help in the detection of high-risk elderly patients undergoing elective hepatectomy.
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Metadata
Title
A New Preoperative Risk Score for Predicting Postoperative Complications in Elderly Patients Undergoing Hepatectomy
Authors
Koichi Tomita
Itsuki Koganezawa
Masashi Nakagawa
Shigeto Ochiai
Takahiro Gunji
Kei Yokozuka
Yosuke Ozawa
Kosuke Hikita
Toshimichi Kobayashi
Toru Sano
Naokazu Chiba
Shigeyuki Kawachi
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-05985-w

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